VALUE BASED OPHTHALMOLOGY

Quality of life and systemic comorbidities in patients with ophthalmic disease

Melissa M Brown^1,2, Gary C Brown^1,3, Sanjay Sharma^1,4, Hussein Hollands¹ and Jennifer Landy¹

Series editors: Melissa Brown and Gary Brown

¹ Center for Evidence-Based Health Care Economics, Flourtown, PA, USA
² The Cataract and General Eye Care Service
³ The Retina Vascular Unit
⁴ Wills Eye Hospital, Jefferson Medical College, Philadelphia, and the Center for Cost-Effective Ocular Health Policy, Queens Medical College, Kingston, Ontario

Correspondence to:
Correspondence to:
Melissa M Brown, MD, MN, MBA, Center for Evidence-Based Health Care Economics, Suite 210, 1107 Bethlehem Pike, Flourtown, PA 19031, USA;
Lissa1011{at}aol.com

Aim: To ascertain the effect of serious systemic comorbidities upon the quality of life of patients with ophthalmic diseases.

Methods: Time tradeoff utility values were obtained in consecutive ophthalmic patients who presented with ocular disease. Multivariate analysis was undertaken to evaluate whether the systemic comorbidities of diabetes mellitus, heart disease, cancer, cerebrovascular accident, and/or renal failure requiring dialysis influenced ocular utility values.

Results: Among the 390 patients with ocular diseases studied, 250 had the systemic comorbidities of diabetes mellitus, heart disease, cancer, stroke, and/or renal failure requiring dialysis, while 140 lacked these comorbidities. There was no statistically significant difference (p = 0.091) between the comorbidity and no comorbidity groups in self assessed quality of life as measured by ocular utility values after taking into account potentially confounding variables.

Conclusions: In patients with ocular disease, ocular utility values related to the visual loss do not appear to be affected by the presence of select, concomitant, serious systemic diseases. Thus, visual loss seems to cause a similar diminution in self assessed quality of life in those who do and do not have serious associated systemic comorbidities. This information has important implications for the calculation of cost effective analyses.

Keywords: utilities; comorbidities; quality of life

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

• Sun, X, Zhang, S, Wang, N, Liang, Y, Wang, L, Fan, S, Sun, L (2009). Utility assessment among patients of primary angle closure/glaucoma in China: a preliminary study. Br. J. Ophthalmol. 93: 871-874 [Abstract] [Full Text]  
• Brown, M. M., Brown, G. C., Brown, H. C., Peet, J., Roth, Z. (2009). Value-Based Medicine, Comparative Effectiveness, and Cost-effectiveness Analysis of Topical Cyclosporine for the Treatment of Dry Eye Syndrome. Arch Ophthalmol 127: 146-152 [Abstract] [Full Text]  
• Godshalk, A N, Brown, G C, Brown, H C, Brown, M M (2008). The power of hope: being a doctor is more than relying solely on the numbers. Br. J. Ophthalmol. 92: 783-787 [Abstract] [Full Text]  
• Real, F J, Brown, G C, Brown, H C, Brown, M M (2008). The effect of comorbidities upon ocular and systemic health-related quality of life. Br. J. Ophthalmol. 92: 770-774 [Abstract] [Full Text]  
• Dale, W., Basu, A., Elstein, A., Meltzer, D. (2008). Predicting Utility Ratings for Joint Health States from Single Health States in Prostate Cancer: Empirical Testing of 3 Alternative Theories. Med Decis Making 28: 102-112 [Abstract]  
• Globe, D. R., Varma, R., Torres, M., Wu, J., Klein, R., Azen, S. P., for the Los Angeles Latino Eye Study Group, (2005). Self-reported Comorbidities and Visual Function in a Population-Based Study: The Los Angeles Latino Eye Study. Arch Ophthalmol 123: 815-821 [Abstract] [Full Text]